|
Albumin (microalbumin) 24 hour urine quantitative
|
$133.00 |
$133.00 |
$133.00 |
$57.60
|
|
Albumin serum plasma or whole blood
|
$126.70 |
$126.70 |
$126.70 |
$42.40
|
|
Alcohol (ethanol) any specimen except urine/breath
|
$181.30 |
$181.30 |
$181.30 |
$94.90
|
|
Alkaline phosphatase
|
$147.00 |
$147.00 |
$147.00 |
$46.80
|
|
Allergen alpha lactalbumin ige
|
$137.20 |
$137.20 |
$137.20 |
$48.57
|
|
Allergen egg white ige
|
$594.30 |
$594.30 |
$594.30 |
$37.20
|
|
Allergen specific ige qual multi scrn ea
|
$29.40 |
$29.40 |
$29.40 |
$24.00
|
|
Allergy injections; 2 or more 95117
|
$37.10 |
$37.10 |
$37.10 |
$43.75
|
|
Allergy injection; single 95115
|
$54.60 |
$54.60 |
$54.60 |
$45.00
|
|
Allograft allowrap 4x4cm dry 16sqcm
|
$1,592.49 |
$1,592.49 |
$1,592.49 |
$5,401.92
|
|
Allograft amnioexcel plus 17mm disk
|
$1,166.90 |
$1,166.90 |
$1,166.90 |
$507.30
|
|
Allograft dermis 20x25x1mm decell w/matracell arthroflex
|
$2,363.09 |
$2,363.09 |
$2,363.09 |
$6,414.50
|
|
Allograft ecm allopatch hd dehydr thick 0.8-1.7mmx2x5cm-cost per sq cm
|
$4,885.38 |
$4,885.38 |
$4,885.38 |
$21,790.11
|
|
Allograft epieffect 2x3cm-q4186-cost per sq cm
|
$1,396.50 |
$1,396.50 |
$1,396.50 |
$858.66
|
|
Allograft membrn amnio 1x2cm hu ambriodry
|
$5,506.09 |
$5,506.09 |
$5,506.09 |
$5,096.00
|
|
Allograft umbil cord+amniotic membrane-q4148-cost per sq cm
|
$1,995.00 |
$1,995.00 |
$1,995.00 |
$5,152.95
|
|
Allograft umbilical epicord 15 sq cm-q4187-cost per sq cm
|
$2,598.40 |
$2,598.40 |
$2,598.40 |
$1,777.39
|
|
Alpha-1-proteinase inhibitor (human) 1,000 mg (+/-) IV solution
|
$3,982.30 |
$3,982.30 |
$3,982.30 |
$12.50
|
|
Alpha-fetoprotein afp-l3 frac & total
|
$317.10 |
$317.10 |
$317.10 |
$189.15
|
|
Alpha-fetoprotein amniotic
|
$144.90 |
$144.90 |
$144.90 |
$89.04
|
|
Alpha-fetoprotein tumor marker
|
$362.60 |
$362.60 |
$362.60 |
$103.80
|
|
Alprostadil for injection
|
$1,355.90 |
$1,355.90 |
$1,355.90 |
$511.84
|
|
Als1-emergency
|
$2,253.30 |
$2,253.30 |
$2,253.30 |
$1,103.37
|
|
Als 2
|
$2,981.30 |
$2,981.30 |
$2,981.30 |
$1,288.56
|
|
Alteplase 100 mg infusion from pyxis vial
|
$56,853.12 |
$56,853.12 |
$56,853.12 |
$15,857.45
|
|
Alt/sgpt
|
$154.70 |
$154.70 |
$154.70 |
$47.40
|
|
Aluminum - quest
|
$214.20 |
$214.20 |
$214.20 |
$81.49
|
|
Alys cplx sp/pn npgt w/prgrm
|
$211.40 |
$211.40 |
$211.40 |
$411.45
|
|
Amantadine (symmetrel)-sendout
|
$328.30 |
$328.30 |
$328.30 |
$179.70
|
|
Amifostine
|
$9,360.22 |
$9,360.22 |
$9,360.22 |
$2,121.39
|
|
Amikacin 4 mg/ml intravitreal injection - cnr
|
$80.15 |
$80.15 |
$80.15 |
$40.40
|
|
Amino acids quant 2-5
|
$236.60 |
$236.60 |
$236.60 |
$113.60
|
|
Aminocaproic acid 5 g/250 ml 0.9% nacl IV - cnr
|
$243.25 |
$243.25 |
$243.25 |
$37.33
|
|
Aminolevulinic acid delta
|
$267.40 |
$267.40 |
$267.40 |
$85.15
|
|
Aminophylline 25 mg/ml intravenous solution (wrapper)
|
$295.92 |
$295.92 |
$295.92 |
$46.24
|
|
Amiodarone 150 mg/100 ml (1.5 mg/ml) in dextrose, iso-osmotic IV
|
$722.75 |
$722.75 |
$722.75 |
$114.96
|
|
Amiodarone 50 mg/ml intravenous solution
|
$232.75 |
$232.75 |
$232.75 |
$55.86
|
|
Amitriptyline (elavil) -sendout
|
$24.50 |
$24.50 |
$24.50 |
$84.56
|
|
Amivantamab-vmjw 50 mg/ml intravenous solution
|
$35,457.62 |
$35,457.62 |
$35,457.62 |
$8,941.39
|
|
Ammonia
|
$243.60 |
$243.60 |
$243.60 |
$119.70
|
|
Amniocentesisdiagnostic 59000
|
$7,121.10 |
$7,121.10 |
$7,121.10 |
$923.50
|
|
Amniocentesis therapeutic
|
$607.60 |
$607.60 |
$607.60 |
$791.05
|
|
Amniotic fluid scan
|
$231.70 |
$231.70 |
$231.70 |
$49.01
|
|
Amp f/th 1/2 jt/phalanx w/neurect local flap
|
$2,036.30 |
$2,036.30 |
$2,036.30 |
$3,735.51
|
|
Amphetamine confirm urine -sendout
|
$207.20 |
$207.20 |
$207.20 |
$93.61
|
|
Amphotericin b in d5w IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$623.87 |
$623.87 |
$623.87 |
$117.75
|
|
Amphotericin b liposomal in d5w IV syringe 1 mg/ml (neo/ped) - cnr
|
$1,749.82 |
$1,749.82 |
$1,749.82 |
$519.03
|
|
Ampicillin 1 gram solution for injection
|
$854.87 |
$854.87 |
$854.87 |
$58.35
|
|
Ampicillin-sulbactam 1.5 gram solution for injection
|
$866.42 |
$866.42 |
$866.42 |
$54.57
|
|
Amplification real-time pcr dna markers infectious disease bacterial vaginosis and vaginitis
|
$299.60 |
$299.60 |
$299.60 |
$262.99
|
|
Amputation toe interphalangeal joint
|
$7,468.30 |
$7,468.30 |
$7,468.30 |
$4,196.50
|
|
Amylase
|
$224.00 |
$224.00 |
$224.00 |
$89.04
|
|
Ana ds-dna
|
$128.80 |
$128.80 |
$128.80 |
$55.25
|
|
Analgesics non-opioid definitive assay 1 or 2 acetaminophen
|
$108.50 |
$108.50 |
$108.50 |
$117.01
|
|
Anal pressure record
|
$1,057.00 |
$1,057.00 |
$1,057.00 |
$946.24
|
|
Anal/urinary muscle study
|
$617.40 |
$617.40 |
$617.40 |
$587.40
|
|
Analysis gene f2 20210g>a variant
|
$664.30 |
$664.30 |
$664.30 |
$222.05
|
|
Analysis gene f5 leiden variant
|
$662.90 |
$662.90 |
$662.90 |
$237.60
|
|
Analyze neurostimulator simple w/reprogramming 95971
|
$494.90 |
$494.90 |
$494.90 |
$375.00
|
|
Anaplsma phgcytophlm amp prb
|
$81.20 |
$81.20 |
$81.20 |
$82.65
|
|
Anca screen with reflex to titer -quest
|
$800.80 |
$800.80 |
$800.80 |
$99.00
|
|
An cholangiogram percutaneous compl
|
$2,730.20 |
$2,730.20 |
$2,730.20 |
$2,494.35
|
|
Androstanediol
|
$196.70 |
$196.70 |
$196.70 |
$131.04
|
|
An fluoro guide for cvp
|
$899.50 |
$899.50 |
$899.50 |
$515.00
|
|
Angio balloon ctrl dialysis seg add-on
|
$18,171.48 |
$18,171.48 |
$18,171.48 |
$5,500.00
|
|
Angioplasty fem/pop unilat 37224
|
$38,218.73 |
$38,218.73 |
$38,218.73 |
$8,835.00
|
|
Angioplasty/iliac/init ves/unilat 37220
|
$16,831.99 |
$16,831.99 |
$16,831.99 |
$10,173.90
|
|
Angioplasty tib/pero/unilat/ea add 37232
|
$166,195.88 |
$166,195.88 |
$166,195.88 |
$5,950.50
|
|
Angiotensin ii
|
$43.40 |
$43.40 |
$43.40 |
$55.44
|
|
Angiotensin ii 0.5 mg/ml soln 1 ml vial
|
$5,594.57 |
$5,594.57 |
$5,594.57 |
$2,792.09
|
|
Angio tib/peroneal/init ves/unila 37228
|
$111,805.40 |
$111,805.40 |
$111,805.40 |
$10,513.36
|
|
Angio trnslmnl balloon same artery ea addl
|
$3,962.70 |
$3,962.70 |
$3,962.70 |
$4,560.40
|
|
Angio trnslmnl balloon same artery ini
|
$60,111.38 |
$60,111.38 |
$60,111.38 |
$9,074.63
|
|
Angio trnslmnl balloon same vein ea addl
|
$65,123.06 |
$65,123.06 |
$65,123.06 |
$4,390.75
|
|
Angio trnslmnl balloon same vein ini
|
$56,159.87 |
$56,159.87 |
$56,159.87 |
$8,466.00
|
|
Ankle arthroscopy/surgery
|
$39,204.77 |
$39,204.77 |
$39,204.77 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$33,044.54 |
$33,044.54 |
$33,044.54 |
$6,193.84
|
|
Ankle arthroscopy/surgery
|
$43,367.25 |
$43,367.25 |
$43,367.25 |
$3,839.54
|
|
Ankle arthroscopy/surgery
|
$31,649.87 |
$31,649.87 |
$31,649.87 |
$3,839.54
|
|
Ankle X-ray
|
$541.80 |
$541.80 |
$541.80 |
$352.80
|
|
Anl sp inf pmp w/mdreprg&fil
|
$1,063.30 |
$1,063.30 |
$1,063.30 |
$627.94
|
|
Anodyne therapy charges pt
|
$25.20 |
$25.20 |
$25.20 |
$42.00
|
|
Anora (draw only)
|
$78.40 |
$78.40 |
$78.40 |
$35.00
|
|
Anoscopy and biopsy
|
$20,858.42 |
$20,858.42 |
$20,858.42 |
$1,670.25
|
|
Anoscopy and dilation 46604
|
$3,705.80 |
$3,705.80 |
$3,705.80 |
$1,621.60
|
|
Anoscopy remove fb 46608
|
$340.20 |
$340.20 |
$340.20 |
$1,374.60
|
|
Ans parasymp & symp w/tilt
|
$205.10 |
$205.10 |
$205.10 |
$368.50
|
|
Ant colporrhaphy/rpr cyctocele 57240
|
$36,542.04 |
$36,542.04 |
$36,542.04 |
$5,468.70
|
|
Antibody bacterium, not elsewhere specified
|
$91.00 |
$91.00 |
$91.00 |
$57.81
|
|
Antibody elution rbc reference
|
$200.20 |
$200.20 |
$200.20 |
$175.50
|
|
Antibody htlv/hiv confirm test
|
$464.10 |
$464.10 |
$464.10 |
$131.28
|
|
Antibody htlv-i
|
$121.80 |
$121.80 |
$121.80 |
$49.53
|
|
Antibody htlv-ii
|
$177.10 |
$177.10 |
$177.10 |
$46.15
|
|
Antibody identification platelet antibodies heparin-pf4 igg
|
$703.50 |
$703.50 |
$703.50 |
$219.30
|
|
Antibody id rbc panel
|
$313.60 |
$313.60 |
$313.60 |
$290.21
|
|
Antibody influenza virus
|
$152.60 |
$152.60 |
$152.60 |
$53.90
|
|
Antibody lymphocytic choriomeningitis
|
$27.30 |
$27.30 |
$27.30 |
$46.20
|
|
Antibody screen rbc
|
$165.20 |
$165.20 |
$165.20 |
$106.88
|
|
Antibody tetanus
|
$86.10 |
$86.10 |
$86.10 |
$54.00
|
|
Antidepressant not specified
|
$207.20 |
$207.20 |
$207.20 |
$72.14
|
